Clinical Findings in Symptomatic Patients With Radiologically Isolated Sphenoid Sinus Disease: A Systematic Review and Meta-Analysis.

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2025-03-04 DOI:10.1111/coa.14300

Zahir Mughal, Keshav Kumar Gupta, Karan Jolly, Thomas Beech, Satvir Minhas, Nicholas Turner

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引用次数: 0

Abstract

Objective: To explore the clinical presentations of isolated sphenoid sinus disease (ISSD).

Setting and design: A literature search was conducted on 23 December 2023 across electronic databases including Medline, Embase, Web of Science, and Cochrane. We performed a meta-analysis of proportions using a random-effects model to determine the prevalence of clinical findings in patients who presented with symptoms and had ISSD on radiological imaging. Sensitivity and subgroup analyses were employed to investigate sources of heterogeneity. The PRISMA guideline was followed.

Participants: This study included patients with clinically significant isolated sphenoid sinus opacification on cross-sectional imaging.

Main outcome measure: The pooled prevalence of clinical symptoms and signs.

Results: A total of 18 studies met the eligibility criteria, encompassing over 1000 patients. The prevailing symptoms were headache in 67.9% (95% CI 62.9-72.7), nasal symptoms 29.7% (95% CI 25.2-34.4), and visual disturbance 14.0% (95% CI 9.3-19.3). Subgroup analysis revealed a significant difference between neoplastic and inflammatory diagnoses concerning the development of visual symptoms (38.3% versus 15.5%, p = 0.0005). A negative nasendoscopic examination was found in 52.0% (95% CI 41.0-62.8) of cases.

Conclusions: Headache emerged as the primary symptom of ISSD, followed by nasal and visual symptoms. Nasendoscopy had a high false negative rate, highlighting its limitation in assessing this condition. Our study highlights the key clinical findings associated with ISSD, which may indicate the need for imaging.

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影像学孤立性蝶窦疾病有症状患者的临床表现：系统回顾和荟萃分析。

目的：探讨孤立性蝶窦病（ISSD）的临床表现。设定与设计：于2023年12月23日在Medline、Embase、Web of Science和Cochrane等电子数据库中进行文献检索。我们使用随机效应模型进行了一项比例荟萃分析，以确定在放射影像上出现症状并患有ISSD的患者中临床表现的患病率。采用敏感性和亚组分析来调查异质性的来源。遵循PRISMA指南。参与者：本研究包括在横断成像上有临床显著孤立性蝶窦混浊的患者。主要结局指标：临床症状和体征的总患病率。结果：共有18项研究符合入选标准，包括1000多名患者。主要症状为头痛67.9% (95% CI 62.9-72.7)，鼻症状29.7% (95% CI 25.2-34.4)，视力障碍14.0% （95% CI 9.3-19.3）。亚组分析显示，肿瘤和炎症诊断在视觉症状发展方面存在显著差异（38.3%对15.5%,p = 0.0005）。52.0% （95% CI 41.0 ~ 62.8）的病例鼻内镜检查呈阴性。结论：头痛是ISSD的主要症状，其次为鼻和视觉症状。鼻内窥镜检查有很高的假阴性率，突出了其在评估这种情况的局限性。我们的研究强调了与ISSD相关的关键临床发现，这可能表明需要影像学检查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.